Can abdominal muscles be tightened laparoscopically? For those who don't need fat or skin removed down there?

Question

Some people do not want or need excess skin removal in the abdominal area, just need the stomach to stick out a little less!

Ronald J. Edelson, MD · Answer

Abdominal muscles can be tightened laparoscopically. It has been described in plastic surgery literature. However very few surgeons do it. I would not pursue the idea.

Semih Yildiz, MD, FEPOBRAS · Answer

In selected patients, tightening a separated abdominal wall can be done with a limited-incision, endoscopic, or laparoscopic-type approach, but it is not the standard answer for everyone. The usual tummy tuck gives the surgeon direct access to repair rectus diastasis while also removing loose skin. If someone truly has no loose skin or extra fat and only has muscle separation, a minimally invasive repair may be worth discussing, but it is more specialized and not offered by every plastic surgeon.

The key is first figuring out why the abdomen sticks out. It may be rectus diastasis, a hernia, intra-abdominal fat, posture, bloating, or a combination of these. Muscle tightening will not remove visceral fat, flatten bloating, or fix loose skin. An in-person exam, and sometimes imaging if a hernia is suspected, is needed before choosing the operation. If the problem is mild diastasis without skin excess, ask a board-certified plastic surgeon specifically whether they offer mini-abdominoplasty, limited-incision plication, or endoscopic/laparoscopic repair, and what scars, recovery, recurrence risk, and limitations come with each option.

Christopher Pannucci, MD, MS · Answer

Hi AuntKT,
It's possible to tighten the rectus muscles laparoscopically or robotically, from the pre-peritoneal approach. Most plastic surgeons do not perform laparoscopic surgery. This would require a conversation with a general surgeon--I'd suggest seeking one out who has lots of experience with robotic surgery! 
Hope this helps!
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Camille Cash, MD · Answer

Yes, abdominal muscles can be tightened laparoscopically.  However you may have difficulty finding a surgeon to do this for you.  Most patients who desire addressing the abdominal wall could also benefit from skin removal as well.

Mats Hagstrom, MD (license on probation) · Answer

General surgeons have tried what you describe and I’m sure you can find someone willing to do it especially if you’re paying for it.
Results are meager because the muscle fascia is on the outside of the muscle layer and correct muscle tightening requires a re-draping the skin/fat layer in order for it not to accumulate in the midline.
Typically procedures that work well become industry standard and this has not.
There’s a reason patients do not opt for this procedure.
I nobody wants to have a full tummy tuck but it is the correct way to treat pregnancy related skin laxity and or muscle separation.
Choose surgeons based on who delivers the most natural looking belly buttons with a low set scar that follows anatomic contours naturally.
Best,
Mats Hagstrom MD

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Laxity of the abdominal wall may be due to the effects of pregnancy or significant weight fluctuation. It is usually accompanied with lax abdominal skin and soft tissue, requiring abdominoplasty. Laparoscopic rectus muscle plication (and mesh placement if necessary) can be performed if it is the sole cause of abdominal fullness.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

Can abdominal muscles be tightened laparoscopically? For those who don't need fat or skin removed down there?

Answers (6)

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